Abstract
More than half of acute myeloid leukemia (AML) diagnoses are currently made in patients older than 60 years. Furthermore, even if the age-specific incidence remains stable in the coming years, the incidence of AML in elderly people is expected to consistently increase, given the progressive ageing of the general population. Consequently, the treatment of the disease in aged individuals represents a daily challenge in clinical hematology. Several studies have shown that, in current practice, a high fraction of patients older than 60 years is negatively selected for inclusion in clinical trials that are based on intensive chemotherapy. Apart from performance status and comorbidity at diagnosis, other non-clinical factors can significantly affect therapeutic choice including the distance from hematologic institution, presence of a carer, physician's and patient's attitude, and the scientific interest of the physician in a given therapeutic programme. In daily practice, a combination of these factors results in relevant selection of patients for clinical trials. Clearly, preselection of patients with AAC leads to misleading overly optimistic results in some studies. Treatment of AML in the elderly is difficult and well-controlled trials in this group of patients are uncommon. Frequently, higly selected patients are recruited to relatively small phase II unrandomised trials with complete remission (CR) rates ranging from 25 to 70 %. These figures may turn unrealistic in the current practice. The present article reviews results of most relevant studies addressing therapeutic results in elderly patients with AML. Questions to be addressed will include potential selection biases, results with conventional chemotherapy, the therapeutic potential of autologous and allogeneic stem cell transplantation and a critical review of results achieved with newly developed drugs.
| Original language | English |
|---|---|
| Pages (from-to) | 33-41 |
| Number of pages | 9 |
| Journal | Reviews on Recent Clinical Trials |
| Volume | 2 |
| Issue number | 1 |
| DOIs | |
| Publication status | Published - Jan 2007 |
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Keywords
- Acute myeloid leukemia
- Elderly patients
- New drugs
ASJC Scopus subject areas
- Medicine(all)
- Pharmacology
Cite this
Acute myeloid leukemia in the elderly : Current therapeutic results and perspectives for clinical research. / Ferrara, Felicetto; Pinto, Antonio.
In: Reviews on Recent Clinical Trials, Vol. 2, No. 1, 01.2007, p. 33-41.Research output: Contribution to journal › Article
}
TY - JOUR
T1 - Acute myeloid leukemia in the elderly
T2 - Current therapeutic results and perspectives for clinical research
AU - Ferrara, Felicetto
AU - Pinto, Antonio
PY - 2007/1
Y1 - 2007/1
N2 - More than half of acute myeloid leukemia (AML) diagnoses are currently made in patients older than 60 years. Furthermore, even if the age-specific incidence remains stable in the coming years, the incidence of AML in elderly people is expected to consistently increase, given the progressive ageing of the general population. Consequently, the treatment of the disease in aged individuals represents a daily challenge in clinical hematology. Several studies have shown that, in current practice, a high fraction of patients older than 60 years is negatively selected for inclusion in clinical trials that are based on intensive chemotherapy. Apart from performance status and comorbidity at diagnosis, other non-clinical factors can significantly affect therapeutic choice including the distance from hematologic institution, presence of a carer, physician's and patient's attitude, and the scientific interest of the physician in a given therapeutic programme. In daily practice, a combination of these factors results in relevant selection of patients for clinical trials. Clearly, preselection of patients with AAC leads to misleading overly optimistic results in some studies. Treatment of AML in the elderly is difficult and well-controlled trials in this group of patients are uncommon. Frequently, higly selected patients are recruited to relatively small phase II unrandomised trials with complete remission (CR) rates ranging from 25 to 70 %. These figures may turn unrealistic in the current practice. The present article reviews results of most relevant studies addressing therapeutic results in elderly patients with AML. Questions to be addressed will include potential selection biases, results with conventional chemotherapy, the therapeutic potential of autologous and allogeneic stem cell transplantation and a critical review of results achieved with newly developed drugs.
AB - More than half of acute myeloid leukemia (AML) diagnoses are currently made in patients older than 60 years. Furthermore, even if the age-specific incidence remains stable in the coming years, the incidence of AML in elderly people is expected to consistently increase, given the progressive ageing of the general population. Consequently, the treatment of the disease in aged individuals represents a daily challenge in clinical hematology. Several studies have shown that, in current practice, a high fraction of patients older than 60 years is negatively selected for inclusion in clinical trials that are based on intensive chemotherapy. Apart from performance status and comorbidity at diagnosis, other non-clinical factors can significantly affect therapeutic choice including the distance from hematologic institution, presence of a carer, physician's and patient's attitude, and the scientific interest of the physician in a given therapeutic programme. In daily practice, a combination of these factors results in relevant selection of patients for clinical trials. Clearly, preselection of patients with AAC leads to misleading overly optimistic results in some studies. Treatment of AML in the elderly is difficult and well-controlled trials in this group of patients are uncommon. Frequently, higly selected patients are recruited to relatively small phase II unrandomised trials with complete remission (CR) rates ranging from 25 to 70 %. These figures may turn unrealistic in the current practice. The present article reviews results of most relevant studies addressing therapeutic results in elderly patients with AML. Questions to be addressed will include potential selection biases, results with conventional chemotherapy, the therapeutic potential of autologous and allogeneic stem cell transplantation and a critical review of results achieved with newly developed drugs.
KW - Acute myeloid leukemia
KW - Elderly patients
KW - New drugs
UR - http://www.scopus.com/inward/record.url?scp=34248382171&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=34248382171&partnerID=8YFLogxK
U2 - 10.2174/157488707779318099
DO - 10.2174/157488707779318099
M3 - Article
C2 - 18473986
AN - SCOPUS:34248382171
VL - 2
SP - 33
EP - 41
JO - Reviews on Recent Clinical Trials
JF - Reviews on Recent Clinical Trials
SN - 1574-8871
IS - 1
ER -